Fever and respiratory symptoms should not be considered a hallmark of COVID-19 in children, concludes a study published in Pediatric Pulmonology.
The systematic review included 38 studies (1,124 cases)published between December 1, 2019 and April 6, 2020. Of 1,117 cases where the severity of disease was recorded, 14.2 per cent were asymptomatic, 36.3 per cent were mild, 46.0 per cent were moderate, 2.1 per cent were severe, and 1.2 per cent were critical.
In adults it has been reported that the most common symptoms are cough (73%), fever (72.8%) and dyspnoea (63%).
This review found that the most prevalent symptoms in children were fever (47.5%), followed by cough (41.5%), nasal symptoms (11.2%), diarrhoea (8.1%), and nausea/vomiting (7.1%).
A total of 145 (36.9%) children were diagnosed with pneumonia, and in 43 (10.9%), upper airway infections were reported. Reduced lymphocyte count was reported in 12.9 per cent of cases.
CT abnormalities were reported in 63.0 per cent of cases. The most prevalent abnormalities reported were ground-glass opacities, patchy shadows and consolidations. Only one death was reported.
The authors concluded that clinical manifestations of children with COVID-19 differ widely from adult cases and say fever and respiratory symptoms should not be considered a hallmark of the disease in children.